Literature Review

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.

Commentary: Prognostication in Alzheimer's disease and related dementias Journal of the American Geriatrics Society / Early View; by Natalie C. Ernecoff PhD, MPH, Kathryn L. Wessell MPH, Laura C. Hanson MD, MPH; 8/8/24  ... Hospice provides comfort-oriented care, emphasizing patient-tailored elements of quality of life, including time with family, access to nature, and music. In late-stage ADRD, studies show that a majority of families prioritize comfort-oriented treatment, and understanding prognosis may help them align treatments accordingly. Yet, only 15% of people enrolled in hospice with a primary diagnosis of ADRD. This is due to difficulty estimating 6-month prognosis required for hospice eligibility—ADRD carries a prognosis of 12–18 months in the latest stage. While low rates of live discharges from hospice are a regulatory requirement for hospices, people who are increasingly experiencing ADRD progression lose access to those beneficial hospice services. ...

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

Baptist Health taps 3 vendors to build a population health system that works Healthcare IT News; by Bill Siwicki; 7/26/24With help from Oracle, Innovaccer and Salesforce, the South Florida provider is scoring big population health wins, including a 7% increase in coding gap closure rate and a 17% increase in annual wellness visit completion rates. Baptist Health South Florida operates a network of 11 hospitals covering four counties. It also includes numerous ambulatory facilities, urgent care centers and emergency departments to provide comprehensive healthcare services across the region. ... "One of our primary issues was the fragmented nature of patient data across multiple provider organizations and electronic health record systems," said Milady Cervera, vice president, population health and physician integrated networks, at Baptist Health South Florida. "This lack of interoperability made it difficult to gain a comprehensive view of our patients' health status, care history and ongoing needs. ..."

Fewer deaths after serious illness in veterans treated with PARC Care Model U.S. Medicine; by LaTina Emerson; 7/11/24 After a serious illness, veterans who received medical care via the Post-Acute Recovery Center (PARC) model experienced fewer deaths and more days outside of the hospital compared to those not treated with PARC, according to a recent study. ...  Using telehealth, PARC is administered by nurse practitioners to address the complex needs of intensive care unit (ICU) survivors as they transition from hospital to home and improve access to post-ICU care for high-risk veterans, ... Each year, “more than 100,000 veterans transition from ICUs to their home after treatment for life-threatening illnesses, but this transition presents many challenges, including unresolved acute medical issues and the lingering effects of acute organ dysfunction,” according to the study authors. ... 

A professional’s perspective: Ageism within the healthcare system; does it exist? Northern Kentucky Tribune; by Jeff Rubin; 7/6/24 A friend of mine named Dee recently shared with me a particularly unpleasant experience she had with a young hospital discharge planner regarding her 97-year-old mom in California. It appears Dee had a heck of a time trying to get her mom discharged to home health care rather than hospice, even though the particular care she needed could have been better delivered at home. A geriatrician by training, Dee ... recognized the invaluable role of hospice in providing end-of-life care. However, the situation she found herself in was less a question of end-of-life and more of palliative care. ...  A recent study in the US sampling 2,035 individuals between 50 and 80 years of age revealed that 93.4% experienced ageism firsthand. Their perception extended to professionals like doctors, nurses, therapists, social workers, and psychologists whose services included working with older people. [Click on the title's link for significant data, descriptions, and resources.]

The hidden advantages of having an older workforce in home health care Home Health Care News; by Joyce Famakinwa; 7/2/24In home health and hospice, the amount of nurses who are at retirement age are set to surpass new RNs, according to data from the American Medical Group Association. St. John has noticed that working with more experienced nurses has meant less turnover. "Our highest turnover is in first-year nurses," she said. Another benefit of having a workforce full of mostly seasoned nurses is that they are better equipped to handle burnout, according to Barnett.

Tuesday Health launches revolutionary Supportive Care solution with $60 million of strategic investment from healthcare leadersInvestors Observier; by PR Newswire; 5/21/24Tuesday Health, a pioneer in value-based care dedicated to transforming serious illness, has launched its innovative supportive care solution in partnership with Valtruis, Blue Venture Fund, Mass General Brigham Ventures , and CareSource. This alliance brings a $60 million strategic investment to Tuesday Health, fueling its mission to redefine supportive care for patients and caregivers facing serious illnesses. "Leveraging clinical expertise, advanced data solutions, and cutting-edge technology, while partnering with Ohio's largest Medicaid plan, its largest hospice provider and the unmatched palliative care experience of Mass General, Tuesday Health is dedicated to tackling one of healthcare's biggest challenges-providing support and care in the right setting, at the right time, for those facing serious illness", said Jim Wieland, CEO of Tuesday Health.Editor's Note: What is the difference between supportive care and palliative care? Click here for a description from ASCO, the American Society of Clinical Oncology. 

Terminal cancer: What matters to patients and caregivers Medscape Medical News; by Megan Brooks; 5/6/24 What's most important to patients with terminal cancer and their caregivers? New research found that patients and caregivers both tend to prioritize symptom control over life extension but often preferring a balance. Patients and caregivers, however, are less aligned on decisions about cost containment, with patients more likely to prioritize cost containment. ... As patients approached the end of life, neither patients nor caregivers shifted their priorities from life extension to symptom management.

Scientists reveal that nearly all older Americans follow one of nine trajectories in their last three years of life SciTechDaily, by Rutgers University; 3/2/24A Rutgers Health analysis of millions of Medicare records has laid the groundwork for improving end-of-life care by demonstrating that nearly all older Americans follow one of nine trajectories in their last three years of life. “Identifying which paths people actually take is a necessary precursor to identifying which factors send different people down different paths and designing interventions that send more people down whatever path is right for them,” said Olga Jarrín, the Hunterdon Professor of Nursing Research at Rutgers and corresponding author of the study published in BMC Geriatrics.

Study shows 'alarming' sharp increase of colon cancer in younger AmericansThe National Desk, by Jamel Valencia; 1/17/24Colorectal cancer is the leading cause of cancer death in men and the second in women under the age of 50, according to the American Cancer Society's annual report on cancer facts and trends. It indicated that colon cancer moved up from being the fourth leading cause of cancer death in both younger men and women two decades ago to first in men and second in women. Breast cancer leads in women under 50 with 2,251 deaths in 2021.

Memorial Hermann drops Humana Medicare AdvantageBecker's Payer Issues, by Jakob Emerson; 1/4/24Houston-based Memorial Hermann Health System is no longer in network with Humana's Medicare Advantage plans, effective Jan. 1. The 17-hospital system told Houston Public Media that it continues to participate in Humana's commercial network. Humana told the outlet that its Medicare Advantage members who are actively receiving treatment at Memorial facilities, can "continue care until treatment is completed." In November, Memorial Hermann issued termination notices after the reimbursement dispute came to an impasse. It is unclear how many people are affected by the dispute. Along with its hospitals, Memorial has 6,700 affiliated physicians across 260 care delivery sites. Humana is the country's second largest MA insurer, with 5.9 million members as of Nov. 1.